Comparative effect of propofol and sevoflurane on chronic postsurgical pain and cognitive function after cardiac surgery in Chinese elderly patients: A preliminary clinical study

Abstract

Purpose: To compare the effects of propofol and sevoflurane on chronic post-surgical pain and cognitive function after cardiac surgery in Chinese elderly patients. Methods: A total of 200 Chinese patients (aged > 65 years) with confirmed diagnosis of severe chronic artery disease who underwent cardiac surgery were given either propofol or sevoflurane. The following efficacy variables were assessed in both treatment groups: pain using an 11-point NRS after surgery; cognitive function, using Severe Impairment Battery (SIB), Clinician Interview-Based Impression of Change (CIBIC), Mini Mental State Examination (MMSE) scale; as well as psychological well-being and disability, using K10 Psychological Distress Scale K-10 and WHO Disability Assessment Schedule (WHODAS) scale. Incidence of complications and duration of hospital stay were also compared. Results: Pain severity score was significantly lower in patients treated with propofol than in those who received sevoflurane (6.1 vs 8.4; p < 0.05). Psychological well-being measured using K-10 score was similar in both groups (p >0.05). Similarly, there were no meaningful differences in disability score between the two treatment groups (p > 0.05). The severity of signs and symptoms of dementia were similar at baseline visit (p >0.05). Propofol-treated patients had numerically greater relief in signs and symptoms of dementia/cognitive impairment, when compared to the Sevoflurane-treated patients (p >0.05). However, incidence of complications (including adverse events) was comparable in both groups (p > 0.05). Conclusion: Propofol produced significantly greater improvement in post-surgical pain and cognitive functions than sevoflurane after cardiac surgery in Chinese elderly patients.